Could this agency upend the campaign to destroy Obamacare?
The answer is yes:
The prospects for House Republicans’ proposal to repeal and replace Obamacare, unveiled Monday night, may well hinge on one small federal agency. The biggest unanswered questions that dog the new bills drafted by two House committees—and Republicans’ repeal effort, more generally—are how much their plan will cost and how many people will lose insurance. And it’s up to the Congressional Budget Office (CBO), a nonpartisan agency that analyzes the impact of proposed legislation for Congress, to estimate what those figures are likely to be.
Related: House GOP unveils legislation to repeal Obamacare and expand Medicaid
As Avik Roy, a conservative health care expert who advised Mitt Romney’s 2012 presidential campaign, framed it for Forbes Tuesday, “The $2 trillion question is: Does the AHCA explode the deficit, or is it relying on steep Medicaid cuts to keep the deficit in line? We won’t know until the CBO scores the bill.” Roy used the acronym for the American Health Care Act, as House Republicans’ proposal is known.
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It will be days if not weeks for the CBO to produce that “score”—the budgetary impact of the House legislation—as well as to calculate how many people the new plan is likely to cover. The bills, which President Donald Trump endorsed on Tuesday, would radically remake the current health care system, repealing most of the taxes and mandates that helped pay for the expansion of coverage under the 2010 law known as Obamacare; replacing the subsidies for purchasing private insurance with tax credits that will benefit the rich more than the poor; and phasing out the expansion of Medicaid that occurred under Obamacare. GOP leaders in the House, however, aren’t waiting for the CBO: The Ways and Means and Energy and Commerce Committees will hold votes on their sections of the repeal-and-replace legislation Wednesday morning.
The decision to rush the bills forward is drawing fire from various corners of Washington. Not surprisingly, Democrats have condemned the move, with House Minority Leader Nancy Pelosi sending a letter to Republican Speaker Paul Ryan on Tuesday arguing: “The American people and Members have a right to know the full impact of this legislation before any vote in Committee or by the whole House.” Among the questions she said the CBO and Congress’s nonpartisan Joint Committee on Taxation need to answer:
“How many fewer Americans will have health insurance coverage compared to current law in Medicaid and the Marketplace?”
“What happens to the premiums, deductibles, out-of-pocket costs, and average value of insurance plans for those with coverage in the Marketplace?”
“How will the bill impact the federal deficit?”